I had an uplift a year ago this October. Then had implant 4 months later. Had to have a revision as my implant on the left side had bottomed out. I am now 5 months down the line and it’s happened again. I’ve had a handful of days without my support bra due to what I’ve been wearing but apart from that I wear all day everyday. I will need another revision as when it drops it becomes achy and uncomfortable. Is there something that can be done so it doesn’t happen again
Answer: Bottoming out Hi, thanks for your question. Following a face to face assessment the options are likely to include: using an alternative type of implant to reduce the risk of recurrence, change the plane of the implant (from below the muscle to above the muscle, assuming the implant is below the muscle), tighten up the skin at the bottom of the breast using a ‘melon slice’ technique, or to use an ‘internal bra’ to support the weight of the implant. This can take the form of using your own tissues, or reinforcing your own tissues with an absorbable mesh. A combination of techniques is likely to be required. I would recommend consulting a plastic surgeon with a specialist interest in aesthetic breast surgery.
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Answer: Bottoming out Hi, thanks for your question. Following a face to face assessment the options are likely to include: using an alternative type of implant to reduce the risk of recurrence, change the plane of the implant (from below the muscle to above the muscle, assuming the implant is below the muscle), tighten up the skin at the bottom of the breast using a ‘melon slice’ technique, or to use an ‘internal bra’ to support the weight of the implant. This can take the form of using your own tissues, or reinforcing your own tissues with an absorbable mesh. A combination of techniques is likely to be required. I would recommend consulting a plastic surgeon with a specialist interest in aesthetic breast surgery.
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September 23, 2024
Answer: Bottoming out Hello,Recurrent “bottoming out” is often a combination of implant characteristics and poor soft tissue support. Larger, smooth implants are more likely to lead to implant malposition. In addition to changing the implant, you may want to ask your surgeon about utilizing either an absorbable mesh or an ADM to provide additional support. Good luck.
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September 23, 2024
Answer: Bottoming out Hello,Recurrent “bottoming out” is often a combination of implant characteristics and poor soft tissue support. Larger, smooth implants are more likely to lead to implant malposition. In addition to changing the implant, you may want to ask your surgeon about utilizing either an absorbable mesh or an ADM to provide additional support. Good luck.
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September 22, 2024
Answer: Bottoming out after breast lift I see you have what we call pseudoptosis on your left breast left greater than right.
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September 22, 2024
Answer: Bottoming out after breast lift I see you have what we call pseudoptosis on your left breast left greater than right.
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September 22, 2024
Answer: Bottoming out Many times, revision with a graft (like galaflex or Durasorb) can prevent bottoming out. However, I’ve seen cases where the muscle is either released too much or naturally “window-shades” over time. This means that the muscle has pulled upwards and created a tight band above your implant, so every time you use your arm it pushes down on the implant. In this case, the only way to get the correct implant position is to convert to a pocket above the muscle, which has its own drawbacks. I recommend asking your original surgeon about the technique used during your revision. If a graft has already been used, it’s more likely that won’t work.
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September 22, 2024
Answer: Bottoming out Many times, revision with a graft (like galaflex or Durasorb) can prevent bottoming out. However, I’ve seen cases where the muscle is either released too much or naturally “window-shades” over time. This means that the muscle has pulled upwards and created a tight band above your implant, so every time you use your arm it pushes down on the implant. In this case, the only way to get the correct implant position is to convert to a pocket above the muscle, which has its own drawbacks. I recommend asking your original surgeon about the technique used during your revision. If a graft has already been used, it’s more likely that won’t work.
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September 22, 2024
Answer: Bottoming out implant after revision - is there something that can be done so it doesn’t happen again? Thank you for your question and photo. A photo with your arms at the side and not raised and side views would've been helpful. Based on this photo, you do have a well formed inframammary crease on both sides, although the left one is lower. You do not have bottoming out by strict definition. The inframammary incision which originally was in the breast crease, now traveled up to the lower pole of your breast. In my opinion, there are two reasons for this: 1. the anchor or Wise pattern incision is a poor design. The vertical limb is usually 4.5-5.0cm which is too short for the size of your implants. In your case it should be 8.5-9.5cm. If you measure the distance now from the nipple to the crease, I believe that would the case. 2. your implants are too large, and they have no place to go but stretch the skin inferiorly and laterally. I would recommend waiting a year before reevaluation. If they are truly bottomed out, then you might need a mesh reinforcement for the lower pole and IMF. Good luck.
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September 22, 2024
Answer: Bottoming out implant after revision - is there something that can be done so it doesn’t happen again? Thank you for your question and photo. A photo with your arms at the side and not raised and side views would've been helpful. Based on this photo, you do have a well formed inframammary crease on both sides, although the left one is lower. You do not have bottoming out by strict definition. The inframammary incision which originally was in the breast crease, now traveled up to the lower pole of your breast. In my opinion, there are two reasons for this: 1. the anchor or Wise pattern incision is a poor design. The vertical limb is usually 4.5-5.0cm which is too short for the size of your implants. In your case it should be 8.5-9.5cm. If you measure the distance now from the nipple to the crease, I believe that would the case. 2. your implants are too large, and they have no place to go but stretch the skin inferiorly and laterally. I would recommend waiting a year before reevaluation. If they are truly bottomed out, then you might need a mesh reinforcement for the lower pole and IMF. Good luck.
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